CARE is an Agency-wide, Brain-injury-informed Accommodation Intervention to Improve Trauma-informed Practices of Domestic Violence Advocates

Wednesday, November 9, 2022

9:45 AM – 9:50 AM

Location: Station 10

Presenting Author(s)

Julianna M. Nemeth, PhD

Assistant Professor
Ohio State University, College of Public Health, Division of Health Behavior and Health Promotion
Columbus, Ohio, United States

Non-presenting Author(s)

RR

Rachel Ramirez, MA, MSW, LISW-S

Director of Health and Disability Programs, Founder of The Center on Partner-Inflicted Brain Injury
Ohio Domestic Violence Network
Columbus, Ohio, United States
CD

Christina Debowski, OTD, OTR/L

Contracted Occupational Therapist
Ohio State University College of Public Health, United States
AH

Alice Hinton

Biostatistician
The Ohio State University, United States

Research Objectives: To evaluate the impact of agency-wide adoption of CARE (Connect, Acknowledge, Respond, Evaluate) on raising trauma-informed care (TIC) practices of Domestic Violence (DV) Service Organization (SO) staff.

Design: Differences in composite TIC practice scores were compared through regression analysis from pre- to 1 year post-CARE agency-wide implementation.

Setting: Five diverse DVSOs participated in CARE evaluation, including two in Appalachia.

Participants: A DVSO staff volunteer sample completed online surveys pre- (n=53) and 1-year post- (n=60) CARE implementation.

Interventions: CARE is a brain-injury informed health advocacy and accommodation intervention for use by staff in DVSOs to: CONNECT with survivors; ACKNOWLEDGE brain injury from head trauma and strangulation are prevalent, along with substance use and mental health struggles; RESPOND by providing accommodations within services and supportive referrals; and EVALUATE if response met survivor need. The CARE Advocacy Tools (The Brain Injury and Just Breathe booklets and the Brain Injury Education Card) are used flexibly by staff at DVSOs in CARE implementation.

Main Outcome Measures: Trauma Informed Practice Scales (TIPS) subscales were modified for TIC practices regarding head trauma, strangulation, mental health, suicide, and substance use. The Attitudes Regarding Trauma Informed Care (ARTIC-10 and ARTIC-15) scales were utilized to assess DVSO staff’s attitudes related to their organization’s response to the same issues. DVSO’s ability to facilitate survivor empowerment was assessed using a modified version of the Survivor Defined Practice Scale (SDPS) to gather staff insight.

Results: TIC practices of DVSO staff significantly improved with the agency’s use of CARE in respect to head trauma, strangulation, mental health, suicide, and substance use (TIPS; p < 0.01—p=0.04). CARE increased DVSO staff’s confidence and perception of organizational support in implementing TIC practices (ARTIC; p < 0.01 and p=0.02, respectively) and promoted TIC practices that foster survivor empowerment (SDPS; p < 0.01).

Conclusions: TIC practices at DVSOs improve with CARE.

Author(s) Disclosures: No author has a conflict of interest to declare. This study was funded by OVC grant 2016-XVGX-K012.

Learning Objectives:

Describe how CARE (Connect, Acknowledge, Respond, Evaluate), a brain injury-informed advocacy intervention, is being used by Domestic Violence Service Organizations to increase trauma-informed care practices.
List the agency-wide components of CARE implementation and how it can be used flexibly when working with survivors of domestic violence in various service settings
Access CARE Tools, free of charge, for use in community setting with domestic violence survivors at https://www.odvn.org/brain-injury/ .